Wang Yan, Buckingham-Howes Stacy, Nair Prasanna, Zhu Shijun, Magder Laurence S, Black Maureen M
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
Office of Research, University of Maryland School of Nursing, Baltimore, Maryland.
J Adolesc Health. 2014 Sep;55(3):423-31. doi: 10.1016/j.jadohealth.2014.02.021. Epub 2014 Apr 24.
To examine how prenatal drug exposure (PDE) to heroin/cocaine and behavioral problems relate to adolescent drug experimentation.
The sample included African-American adolescents (mean age = 14.2 years, SD = 1.2) with PDE (n = 73) and a nonexposed community comparison (n = 61). PDE status was determined at delivery through toxicology analysis and maternal report. Internalizing/externalizing problems were assessed during adolescence with the Behavior Assessment System for Children, Second Edition. Drug experimentation was assessed by adolescent report and urine analysis. Logistic regression evaluated the likelihood of drug experimentation related to PDE and behavioral problems, adjusting for age, gender, PDE, perceived peer drug use, and caregiver drug use. Interaction terms examined gender modification.
Sixty-seven subjects (50%) used drugs: 25 (19%) used tobacco/alcohol only and 42 (31%) used marijuana/illegal drugs. Ninety-four subjects (70%) perceived peer drug use. PDE significantly increased the risk of tobacco/alcohol experimentation (odds ratio = 3.07, 95% confidence interval [CI] 1.09-8.66, p = .034) but not after covariate adjustment (adjusted odds ratio [aOR] = 1.16, 95% CI .31-4.33, p > .05). PDE was not related to the overall or marijuana/illegal drug experimentation. The likelihood of overall drug experimentation was doubled per SD increase in externalizing problems (aOR = 2.28, 95% CI 1.33-3.91, p = .003) and, among girls, 2.82 times greater (aOR = 2.82, 95% CI 1.34-5.94, p = .006) per SD increase in internalizing problems. Age and perceived peer drug use were significant covariates.
Drug experimentation was relatively common (50%), especially in the context of externalizing problems, internalizing problems (girls only), older age, and perceived peer drug use. Findings support the Problem Behavior Theory and suggest that adolescent drug prevention addresses behavioral problems and promotes prosocial peer groups.
研究产前接触海洛因/可卡因药物（PDE）与行为问题如何关联青少年药物试验。
样本包括有PDE的非裔美国青少年（平均年龄 = 14.2岁，标准差 = 1.2）（n = 73）和无接触史的社区对照组（n = 61）。通过毒理学分析和母亲报告在分娩时确定PDE状态。在青少年时期使用儿童行为评估系统第二版评估内化/外化问题。通过青少年报告和尿液分析评估药物试验情况。逻辑回归评估与PDE和行为问题相关的药物试验可能性，并对年龄、性别、PDE、感知到的同伴药物使用情况和照顾者药物使用情况进行校正。交互项检验性别差异。
67名受试者（50%）使用过药物：25名（19%）仅使用烟草/酒精，42名（31%）使用大麻/非法药物。94名受试者（70%）感知到同伴使用药物。PDE显著增加了烟草/酒精试验的风险（优势比 = 3.07，95%置信区间[CI] 1.09 - 8.66，p = 0.034），但在进行协变量校正后无显著差异（校正优势比[aOR] = 1.16，95% CI 0.31 - 4.33，p > 0.05）。PDE与总体或大麻/非法药物试验无关。外化问题每增加一个标准差，总体药物试验的可能性增加一倍（aOR = 2.28，95% CI 1.33 - 3.91，p = 0.003），在女孩中，内化问题每增加一个标准差，总体药物试验的可能性增加2.82倍（aOR = 2.82，95% CI 1.34 -
5.94，p = 0.006）。年龄和感知到的同伴药物使用情况是显著的协变量。
药物试验相对常见（50%），尤其是在外化问题、内化问题（仅女孩）、年龄较大以及感知到同伴药物使用的情况下。研究结果支持问题行为理论，并表明青少年药物预防应解决行为问题并促进亲社会同伴群体的形成。
